Hyper-immune plasma for parvo

RE: Hyper-immune plasma for parvo

Robin Grimmer — Wed, 21 Dec 2016 18:23:22 GMT

[quote user="Bob Russell"]

Our parvo puppies are typical 'Gumtree' puppies. Unwitting or gullible buyers.

'Mother is out for a walk' or 'we cannot leave the poor puppy with those awful people' situations.

[/quote]

Had one of these last week. Well meaning client found a jack Russell puppy online. She knew it was a bad place but felt sorry for the puppy. On the way home it passed loads of ascarids. I saw it and warned her re parvo, and lo and behold it came down with parvo a few days later and was euthanased.

RE: Hyper-immune plasma for parvo

Martin Atkinson — Wed, 21 Dec 2016 17:20:59 GMT

[quote user="Bob Russell"]

Our parvo puppies are typical 'Gumtree' puppies. Unwitting or gullible buyers.

'Mother is out for a walk' or 'we cannot leave the poor puppy with those awful people' situations.

[/quote]A fool and his money are soon parted!

RE: Hyper-immune plasma for parvo

Bob Russell — Wed, 21 Dec 2016 15:28:49 GMT

Our parvo puppies are typical 'Gumtree' puppies. Unwitting or gullible buyers.

'Mother is out for a walk' or 'we cannot leave the poor puppy with those awful people' situations.

RE: Hyper-immune plasma for parvo

Martin Atkinson — Wed, 21 Dec 2016 14:31:25 GMT

[quote user="Braden Collins"]I find most dogs with Parvo belong to people who couldn't afford the vaccine, so treating the pet properly is normally out of the question. We expect a deposit of $500 when a part of case is admitted as a way of weeding out those who won't/can't pay.[/quote]Definitely the same here, and when that's run out another deposit. In the fairly recent past, the highest proportion were presented by 'travellers' who had no intention of paying anyway and then play the race card saying I'm prejudiced against them as wouldn't ask anyone else to pay up front. Well I would you p**** so f*** off.

RE: Hyper-immune plasma for parvo

ruths — Wed, 21 Dec 2016 06:52:00 GMT

There's an outpatient protocol for treating osrvo off the premises. I will see if I can find it

it's lead to the name 'carvo' as the dogs don't leave their owner's vehicle

RE: Hyper-immune plasma for parvo

Braden Collins — Wed, 21 Dec 2016 00:20:58 GMT

I find most dogs with Parvo belong to people who couldn't afford the vaccine, so treating the pet properly is normally out of the question.

We use frozen plasma as part of our protocol for those that can afford treatment, but for those who can't we strongly recommend euthanasia as the pups suffer too much.

We expect a deposit of $500 when a part of case is admitted as a way of weeding out those who won't/can't pay.

RE: Hyper-immune plasma for parvo

cathal rafferty — Wed, 21 Dec 2016 00:20:34 GMT

[quote user="Martin Atkinson"]

[quote user="cathal rafferty"]Besides, I work in Ireland[/quote]Probably why I see very few cases. All the Irish puppy farm stock has died before it gets here! Only said partly tongue in cheek.

[/quote]

Definitely a fair point. Things seem to be improving somewhat on that front, definitely more regular seizures of puppies at the ports. I guess it hard to police somebody who just breeds a load of dogs in a shed.

Having said that,there's a market for those pups. When I worked in Wrexham, i'd regularly be presented with sick 4 or 5 week old wretches bought in a car park between there and Holyhead.

Some people eh?

RE: Hyper-immune plasma for parvo

Hannah Wynne Richards — Tue, 20 Dec 2016 17:06:52 GMT

Good idea for the future, but doesn't solve the problem of what to do with the poor puppies which are currently dieing

Wynne

RE: Hyper-immune plasma for parvo

An On MRCVS — Tue, 20 Dec 2016 16:59:07 GMT

There's a perfectly good vaccine cheaply available. It seems a bit unnecessary to be planning to do ground breaking treatment involving a donor animal when there is an alternative. If you are treating these charity dogs for free anyway, why not provide the charity with free/cheap vaccine instead?

If they are owned dogs can you arrange a vaccine drive in conjunction with local charity and get as many vaccinated as possible?

RE: Hyper-immune plasma for parvo

Stefano Zago — Tue, 20 Dec 2016 15:45:10 GMT

As mentioned in previous posts there are no RCTs using plasma in parvo dogs except the small study mentioned. Any evidence is anecdotal. Most criticalists do not use plasma except in cases with concurrent hypoalbuminaemia or coagulation abnormalities relying instead on very intensive care only.

Dr Dodds, a somewhat controversial vet, founder of the first US blood bank, advocate the use of plasma following this protocol: 6-10ml/kg at admission, 12hrs later and again 24hrs later. She report improved survivals but again anecdotal!

RE: Hyper-immune plasma for parvo

Martin Atkinson — Tue, 20 Dec 2016 14:08:34 GMT

[quote user="cathal rafferty"]Besides, I work in Ireland[/quote]Probably why I see very few cases. All the Irish puppy farm stock has died before it gets here! Only said partly tongue in cheek.

RE: Hyper-immune plasma for parvo

Michael Woodhouse — Mon, 19 Dec 2016 21:33:42 GMT

[quote user="Virginia Campbell"]How do you separate the plasma? Just leave heparinised blood to settle by gravity then draw it off the top? [/quote]

That's how I've done it in horses.

Edit - we've frozen plasma from small animals when blood has been collected and not used for some reason or another. Tapped off into a dry bag.

RE: Hyper-immune plasma for parvo

Virginia Campbell — Mon, 19 Dec 2016 21:12:09 GMT

How do you separate the plasma? Just leave heparinised blood to settle by gravity then draw it off the top?

RE: Hyper-immune plasma for parvo

Michael Woodhouse — Mon, 19 Dec 2016 21:00:31 GMT

I suspect that if we were wanting truly hyper-immune plasma then we'd need to collect it from affected and recovered animals. I also suspect that you'd need quite a lot to make an appreciable difference.

I like that someone has found a paper but its not a good paper.

RE: Hyper-immune plasma for parvo

Richard Carter — Mon, 19 Dec 2016 19:02:58 GMT

The problem is the usual one - the theory is sound, the testing hasn't been done and nothing has been standardised so we don't know if 12ml is a good dose or if it has to 20ml or 100ml or if it makes a difference if the donor dog had been vaccinated once, twice, 20 x

On the parvo front - as a student we had an outbreak that filled the quarantine section of the hospital at the uni - as there were more turning up we started doing i/p fluids as outpatients and repeating the next day. Those that got i/p fluids and home care had a higher survival rate than those admitted for i/v fluids and hospitalisation. Don't know if this means more about students running the hospital or that individual care in a home surroundings is a huge factor in survival.

Also remember that if Pasteur, Jenner, Koch and Lister et al had followed the rules, we would still be applying leeches and discussing the humors of the body and dying of smallpox

RE: Hyper-immune plasma for parvo

Hannah Wynne Richards — Sun, 18 Dec 2016 09:55:06 GMT

That sounds horrific

Wynne

RE: Hyper-immune plasma for parvo

cathal rafferty — Sun, 18 Dec 2016 00:42:00 GMT

Martin- Good point... I don't know.

Phil, thanks for the reference.

I didn't mean to start a discussion on the pedantics of home office regulation. For various reasons, I see lots of parvo, certainly every month. Usually charity dogs with no history of vaccs, often litters that all die after a few days of treatment-very frustrating!

The biggest prognostic factor as far as I can see is age of the dog. Since most of them die and aren't owned by anyone, i would try anything to improve their chances. Talk of virbagen being licensed is irrelevant, there's no one to pay for it.

Besides, I work in Ireland. I can imagine ringing the department to ask it I needed a license for experimentation... the line would go silent as they rolled around on the floor laughing at me.

RE: Hyper-immune plasma for parvo

Martin Atkinson — Sat, 17 Dec 2016 21:45:06 GMT

[quote user="cathal rafferty"]Essentially it involved vaccinating the vet's dog every 6 months to ensure a high antibody titr[/quote]Is there any research that shows that vaccinating more frequently actually results in hyper-immune serum? I would have thought that there is an end point at which the body will not produce anymore antibodies and it becomes a law of diminishing returns.

RE: Hyper-immune plasma for parvo

easy307 — Sat, 17 Dec 2016 21:05:00 GMT

Bragg, R.F. et al (2012) Clinical evaluation of a single dose of immune plasma for treatment of canine parvovirusinfection. JAVMA. 240(6), pp. 700-704

RE: Hyper-immune plasma for parvo

easy307 — Sat, 17 Dec 2016 21:01:15 GMT

Clinical evaluation of a single dose of immune plasma for treatment of canine parvovirus infection

Ryan F. Bragg, dvm, ms, dacvecc; Amanda L. Duffy, dvm, ms, dacvecc; Frank A. DeCecco, dvm; Donald K. Chung, dvm; Maura T. Green; Julia K. Veir, dvm, phd, dacvim; Steven W. Dow, dvm, phd, dacvim

Objective—To evaluate the efficacy of administration of a single 12-mL dose of canine parvovirus (CPV)-immune plasma for treatment of CPV enteritis. Design—Prospective, randomized, double-blinded, placebo-controlled clinical trial. Animals—14 dogs with naturally occurring CPV enteritis.

Procedures—Dogs were assigned to treatment groups on the basis of randomization tables and were administered a single IV dose of CPV-immune plasma (treatment group) or an equivalent volume of saline (0.9% NaCl) solution (placebo group) within 18 hours after admission to the hospital.

Treatment and outcome variables evaluated included neutrophil, monocyte, and CPV counts; number of days of hospitalization; changes in body weight; and cost of treatment. Results—When dogs treated with CPV-immune plasma were compared with dogs treated with saline solution, there were no significant differences detected among neutrophil or monocyte counts, magnitude of viremia, weight change, number of days of hospitalization, or cost of treatment.

Conclusions and Clinical Relevance—Administration of a single 12-mL dose of immune plasma soon after the onset of CPV enteritis in dogs was not effective in ameliorating clinical signs, reducing viremia, or hastening hematologic recovery.

RE: Hyper-immune plasma for parvo

Dinu Catilina — Sat, 17 Dec 2016 18:28:32 GMT

[quote user="Richard Carter"]

I would rather we had more Noel Fitpatricks pushing the boundaries than the cover your behind / defensive medicine we are drifting into.

[/quote]

I would rather not have more of them. Mr Fitzpatrick is not a first opinion practitioner but a RCVS recognised specialist (correct me if I am wrong) who does what he does in a regulated and controlled research environment.

[quote user="Richard Carter"]

There is a very real problem of first opinion vets having less skills than their predecessors because of not being prepared to try.

[/quote]

I would like to call a very polite bullshit on this statement, do you have any evidence on this? New graduates may not be always competent in surgery but they are certainly more competent ( in my opinion) in internal medicine than their predecessors 30 years ago.

RE: Hyper-immune plasma for parvo

Malcolm Ness — Sat, 17 Dec 2016 17:53:49 GMT

[quote user="Evelyn Barbour-Hill"]Not quite the same ..... [/quote]

You are applying common sense but this is the law!!

[quote user="Evelyn Barbour-Hill"]Hmm, if a veterinary surgeon needs a Home Office licence to keep a pet greyhound that will be required to donate blood occasionally, I've been breaking the law for years and I doubt if I'm the only one.[/quote]

That is the point - this (blood collection) is strictly speaking NOT an act of veterinary surgery and as you imply, should be done under Home Office supervision. I believe that VetsNOW encountered this when they started up their Blood Products Service and that something of a "blind eye" is turned when it comes to blood transfusions and the like in clinical practice. From a strictly legal stand point, as veterinary surgeons we should be able to defend our actions as "normal acts of veterinary medicine/surgery" and a key aspect of that is that we should be able to demonstrate a benefit, or at least an expected benefit, to the animal we are treating. There is no demonstrable or potential benefit to the "donor" of harvesting plasma. Hence the legal difficulty - the same one which prevents researchers drawing blood samples from healthy dogs to use as controls and obliging them instead to use the "leftovers" of samples drawn for bona fide reasons.

RE: Hyper-immune plasma for parvo

Evelyn Barbour-Hill — Sat, 17 Dec 2016 17:06:15 GMT

[quote user="Malcolm Ness"]

.......... or taking a kidney from a healthy cat and implanting in a sick one.

It is certainly a question of scale but I think there are the same ethico-legal considerations with harvesting kidneys and/or plasma.

[/quote]

Not quite the same ..... the whole point about blood donation is that the donor makes it up again in a few days, and blood is a tissue in constant turnover anyway. Whereas kidney donation permanently deprives the donor of a kidney. (Yes, I know the remaining one hypertrophies a bit, in man anyway, not sure about the cat, but that's not the point).

Hmm, if a veterinary surgeon needs a Home Office licence to keep a pet greyhound that will be required to donate blood occasionally, I've been breaking the law for years and I doubt if I'm the only one.

RE: Hyper-immune plasma for parvo

Malcolm Ness — Sat, 17 Dec 2016 14:18:25 GMT

[quote user="Richard Carter"]so why is not taking plasma or serum from a healthy well vaccinated dog and giving it to a sick one?[/quote]

.......... or taking a kidney from a healthy cat and implanting in a sick one.

It is certainly a question of scale but I think there are the same ethico-legal considerations with harvesting kidneys and/or plasma.

RE: Hyper-immune plasma for parvo

Richard Carter — Sat, 17 Dec 2016 12:19:33 GMT

you as a scientist are also quite aware of how antibodies work as opposed to immunostimulants so we are not comparing apples with apples.

I would rather we had more Noel Fitpatricks pushing the boundaries than the cover your behind / defensive medicine we are drifting into. There is a very real problem of first opinion vets having less skills than their predecessors because of not being prepared to try.